Dental care for vulnerable young children

Dental caries is the most common chronic disease of childhood, and the burden falls mainly on disadvantaged children.

Early childhood caries affect more than four million children in the U.S. In other industrialized countries, 60-90% of schoolchildren and most adults have experienced dental caries, and it also poses a major problem in emerging economies in Asia and Latin America. While caries is still relatively less prevalent in Africa, the number of children and adults affected is expected to rise as Africans consume more sugar.

Over ten years ago, faculty at the Gillings School, the UNC Dental School and other agencies began to notice a dramatic increase in dental disease in young North Carolina children, particularly those from low-income families and those with poor access to dental care. They introduced a cascade of projects targeting Early Head Start programs, pediatricians and family physicians. These projects have educated parents and caregivers, increased access to basic dental services, and helped to prevent tooth decay in preschool children. These projects have proven their effectiveness in preventing dental decay and reducing hospitalizations and future dental costs. The methods used are relevant to other states and countries where dental caries pose a significant problem for child health and health equity. Read More

The projects take place in medical offices that serve Medicaid-eligible children and in Early Head Start (EHS) centers. The North Carolina program has trained about 500 medical offices to provide simple preventive dental services for children, including screening, risk assessment and referral, parent counseling and topical fluoride application. The EHS centers selected to participate in the project are in close proximity to many of these medical offices. EHS staff have being trained to provide dental health education and promotion activities for children and their families, and to link children enrolled in EHS with medical providers in their communities who provide preventive dental services. The EHS training includes statewide forums, educational workshops and resource materials. The trained EHS staff lead prevention activities in their classrooms and counsel parents in oral health practices using motivational interviewing techniques.

This novel approach to dental education, prevention and access to care has improved the oral health and quality of life for preschool children and their families and had reduced the costs of hospitalizations and future dental care.

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